Journal of critical care
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Journal of critical care · Aug 2017
Laboratory and clinical predictors of 30-day survival for patients on Extracorporeal Membrane Oxygenation (ECMO): 8-Year experience at Albert Einstein College of Medicine, Montefiore Medical Center.
Survival of patients on ECMO has remained stable in every population. Laboratory values predictors of survival are required to improve patient care. ⋯ Laboratory markers identified herein may guide the management of patients on ECMO.
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Journal of critical care · Aug 2017
Comparative StudyEfficacy and toxicity of high-dose nebulized colistin for critically ill surgical patients with ventilator-associated pneumonia caused by multidrug-resistant Acinetobacter baumannii.
Few studies have compared nebulized and intravenous (IV) colistin for multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa pneumonia. This study compared the nephrotoxicity and clinical outcomes for these two delivery routes. ⋯ Nebulized colistin may have less nephrotoxicity and provide similar clinical results, compared to IV colistin.
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Journal of critical care · Aug 2017
Observational StudyRelation of positive fluid balance to the severity of renal impairment and recovery among ST elevation myocardial infarction complicated by cardiogenic shock.
We analyzed the relationship between a positive fluid balance and its persistence over time on acute kidney injury (AKI) development, severity and resolution among ST elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock. ⋯ A positive fluid balance was strongly associated with higher stage AKI and lower rate of AKI recovery in STEMI complicated by cardiogenic shock.
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Journal of critical care · Aug 2017
Evaluation of intraventricular colistin utilization: A case series.
Multi-drug resistant organisms (MDROs) are an increasing concern in health systems. Pathogens such as Pseudomonas aeruginosa, Acinetobacter baumanii, and carbapenamase-producing Enterobacteriaceae hold highest mortality rates especially when the central nervous system is involved. When MDROs are cultured treatment options are limited and reliance on medications such as colistin is becoming more prevalent. Penetration of these therapies into the central nervous system is concerning therefore local administration is a potential concomitant therapy. ⋯ The use of intraventricular colistin was associated with positive clinical outcomes with no reported adverse effects.
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Journal of critical care · Aug 2017
Observational StudyThe correlation between CVP-derived parameters and the prognosis of critically ill patients.
To investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically ill patients. ⋯ Exposure to higher levels of central venous pressure in critically ill patients is associated with a poorer prognosis and worse organ function. Therefore, central venous pressure should be kept as low as possible during hemodynamic therapy in critically ill patients.